2of13A person peers into the new California Pacific Medical Center where the automobile drop-off for patients and visitors is inside a tunnel connecting Geary and Post streets.Photo: Photos by Gabrielle Lurie / The Chronicle

For years after it opened in 1960, San Francisco’s most detested modern building was the Jack Tar Hotel — a trio of vividly colored crates that Chronicle architecture critic Allan Temko promptly dubbed “an eruption of nouveau riche Texas boorishness.”

Now the Jack Tar is gone, replaced by a single massive box at the same corner of Geary Street and Van Ness Avenue. Instead of boorish, it’s earnest. Instead of splashy, it’s monochromatic. More than anything else, it’s overbearing — the Bay Area’s latest example of the difficulties of fitting 21st century hospitals into long-established settings.

Simply put, state-of-the-art medical facilities are great to have near you in moments of peril or need. That doesn’t mean you want one as your neighbor.

The newcomer in this case is the Van Ness campus of California Pacific Medical Center, which opened last week and is owned by health care behemoth Sutter Health. The 11-story, 178-foot-tall building is a behemoth as well, with its five-story podium filling the entire block.

Within those masses are roughly 1 million square feet of space filled with everything from a large emergency room entered off Franklin Street to a super-scaled birthing center that fills the top floor of the podium. There are 274 patient beds and 13 operating rooms. The official price tag, including all the equipment, is $2.1 billion.

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I mention such details because, in the words of one member of the design team, “hospitals essentially are designed from the inside out.” Some of this is driven by state requirements, such as larger room-size minimums. Competition is another factor: A new hospital in the Bay Area doesn’t want to debut without the medical bells and whistles being touted by other new facilities a city or two away.

All this makes sense, given the life-and-death stakes that might be involved. But it’s a risky prescription for architectural health.

The problem at Geary and Van Ness isn’t lack of ambition, as was the case with Kaiser Permanente’s terminally bleak Oakland hospital tower that opened in 2014. A design team led by SmithGroup worked mightily in San Francisco to juggle all the demands on a complicated site that climbs 36 feet from Van Ness to Franklin. The first priority is providing efficient care to patients, rightly so, but there also was an effort to make the massive structure seem at home within a dense urban setting surrounded by busy streets.

For instance, the slab-like tower above the podium is arranged as if two bars were pulled slightly apart, so that the ends facing Van Ness and Franklin aren’t as thick as the long middle section. They’re mostly cloaked by a dark-toned glass curtain wall, but the pulled-apart sections within each bar are clad in silvery gray metal panels to add contrast and depth.

As for putting the tower along the south half of the block, this leaves as much light and air as possible for the large condominium complex on the next block to the north — and, no doubt, placate potentially litigious neighbors.

There’s also an uncommonly generous sidewalk corridor alongside Van Ness: The wide path is accompanied by benches set on cobbled paving stones amid a streambed-like bio-swale along the street. The ambiance is almost urbane, no easy feat on construction-hobbled Van Ness, and the landscape architects at Wallace Roberts & Todd deserve credit.

But there’s only so much that architecture can do when the podium floors measure almost 2.5 acres and the slab of the tower is 384 feet long. The automobile drop-off for patients and visitors is inside a tunnel connecting Geary and Post streets, albeit with a digitized bay panorama on one side and a swanky porte-cochère on the other.

At this scale, any mistakes are magnified — and the SmithGroup design team made its share of mistakes.

An obvious one involves the dark glass skin, coupled with dark gray granite along the base and the silvery gray found on the tower.

The overall impact is as glum as it sounds.

Yes, the curtain wall comes with seemingly random window patterns and panes of glass in varied shades of gray and blue. The inspiration, say architects, were the syncopated grids of Dutch painter Piet Mondrian. But compact jolts of color are what brought his grids to hypnotic life.

Monochrome was not Mondrian’s thing.

Another attempt to make the thick tower seem less bulky is that it tapers slightly from the middle toward the edges — one of those gestures that architects love and planners approve, but regular people don’t notice.

Nor is there relief on the ground, gracious Van Ness sidewalk aside. The lone outdoor space is a courtyard on the podium’s top floor, open only to patients and their visitors. By contrast, CPMC’s 120-bed hospital that opened last fall near Bernal Heights at Valencia and Cesar Chavez streets has a friendly public plaza at ground level through the block that will expand as the campus is completed.

The CPMC hospital on Van Ness won’t likely attract the scorn once aimed at the Jack Tar. It serves city residents, not tourists and conventioneers. Van Ness has plenty of other large buildings. New towers are what today get under everyone’s skin.

Grading on the curve of 21st century hospitals — big, bigger, behemoth — at least San Francisco’s newcomer tries. It doesn’t look cheap.

Still, a little bit of color would be nice. Sometimes, nouveau-riche boorishness can be fun.

John King is The San Francisco Chronicle’s urban design critic, taking stock of everything from Salesforce Tower to public spaces and homeless navigation centers. A two-time Pulitzer Prize finalist and author of two books on San Francisco architecture, King joined The Chronicle in 1992 and covered City Hall before creating his current post in 2001. He spent the spring of 2018 as a Mellon Fellow in Urban Landscape Studies at Dumbarton Oaks in Washington, D.C.